MyDay Multifocal lenses offer exceptional comfort and vision correction for presbyopia, utilizing Water Gradient Technology for a uniquely smooth wearing experience.
Successful fitting relies on precise assessment, utilizing the ACUVUE Multifocal Fitting Calculator, and addressing individual patient needs for optimal results.
Understanding Presbyopia and Multifocal Lenses
Presbyopia, a natural age-related process, reduces the eye’s ability to focus on near objects, typically becoming noticeable around age 40. This occurs due to a loss of elasticity in the crystalline lens, impacting accommodation. Consequently, individuals often experience blurred near vision, requiring reading glasses or other corrective measures.
Multifocal lenses address presbyopia by incorporating multiple power zones into a single lens. These zones provide clear vision at various distances – far, intermediate, and near – eliminating the need for switching between different spectacles. MyDay Multifocal lenses specifically employ this technology, utilizing a center-distance design to optimize visual acuity across all ranges.
Understanding the underlying physiological changes of presbyopia and the principles of multifocal lens design is crucial for successful contact lens fitting and patient satisfaction.
The Rise in Presbyopia Prevalence
Presbyopia’s prevalence is experiencing a significant increase globally, driven by the world’s aging population. Current estimates project 1.37 billion individuals will be affected by next year (Fricke et al.). This translates to approximately 1,800 presbyopes for every 1,000 people, highlighting a substantial and growing patient base.
Several factors contribute to this rise, including increased life expectancy and demographic shifts. As individuals live longer, the likelihood of developing age-related conditions like presbyopia naturally increases. This trend presents both a challenge and an opportunity for eye care professionals.
The demand for effective presbyopic corrections, such as MyDay Multifocal lenses, is therefore expected to continue growing, necessitating skilled fitting techniques and comprehensive patient care;
Challenges in Multifocal Contact Lens Fitting
Multifocal contact lens fitting presents unique challenges compared to single-vision corrections. Achieving optimal vision at all distances – near, intermediate, and far – requires careful consideration of individual patient needs and ocular characteristics.
Common issues include haloes and glare, fluctuations in vision, and difficulties with lens centration and movement. These can stem from improper add power selection, inadequate tear film, or corneal irregularities. A significant number of patients don’t receive a presbyopia contact lens correction.
Successfully navigating these hurdles demands a thorough pre-fitting assessment, precise lens selection, and a willingness to refine the fit based on patient feedback and objective measurements.
Patient Selection for MyDay Multifocal Lenses
MyDay Multifocal lenses are ideal for presbyopic patients seeking comfortable, high-quality vision correction. However, not all presbyopes are suitable candidates. Careful patient selection is crucial for success.
Consider patients exhibiting stable refraction, adequate tear film production, and manageable corneal astigmatism. Those motivated and willing to adapt to multifocal vision are more likely to achieve satisfaction.
Clinicians should identify obstacles to successful wear, like dry eye or significant higher-order aberrations. A detailed discussion of expectations and potential limitations is essential. Prioritize patients desiring all-distance vision correction.
Pre-Fitting Assessment
A thorough pre-fitting assessment is paramount for MyDay Multifocal success. Begin with a comprehensive refraction, accurately determining distance and near additions. Precise add power determination minimizes adaptation challenges.
Corneal topography mapping is vital, especially for astigmatism evaluation. Assess tear film quality and quantity; instability can compromise lens comfort and vision. Address any dry eye concerns before proceeding.
Evaluate binocular vision status, including accommodative amplitude and phoria. Document patient lifestyle and visual demands to tailor the fitting approach. A detailed history informs lens selection and expected outcomes.
Refractive Error and Add Power Determination
Accurate refraction is the cornerstone of MyDay Multifocal fitting. Perform a thorough distance and near refraction, monocularly and binocularly. Utilize subjective techniques like retinoscopy and trial frames to refine the prescription.
Determine the appropriate add power based on the patient’s near addition requirement. Consider lifestyle factors; near-intensive tasks may necessitate a higher add. Employ a near addition questionnaire for detailed insights.
Carefully assess intermediate vision needs, as MyDay Multifocal offers excellent performance at all distances. Document all findings meticulously to guide trial lens selection and ensure optimal visual acuity.
Corneal Topography and Astigmatism Evaluation
Corneal topography is crucial for MyDay Multifocal fitting, especially with astigmatism. Map corneal shape to identify irregularities and assess suitability for multifocal designs. Evaluate axial maps for steepening or flattening that could impact lens fit.
Quantify astigmatism magnitude and axis; higher astigmatism may require toric multifocal lenses. Consider posterior corneal astigmatism, as it influences overall refractive error. Analyze corneal eccentricity to predict lens centration and movement.
Topographic data informs diagnostic set selection, optimizing lens performance and minimizing aberrations. Accurate astigmatism correction enhances visual clarity and patient comfort with MyDay Multifocal lenses.
Tear Film Assessment
A comprehensive tear film assessment is vital before fitting MyDay Multifocal lenses. Evaluate tear volume using Schirmer’s test or capillary action methods to identify dry eye. Assess tear film osmolarity and non-invasive breakup time (NITBUT) for stability.
Address any tear film deficiencies before proceeding with lens fitting, as instability impacts lens comfort and visual performance. Consider artificial tears or punctal plugs to optimize the ocular surface.
MyDay Multifocal’s Water Gradient Technology promotes comfort, but a healthy tear film is still essential. Proper tear film management maximizes lens acceptance and minimizes complications.
MyDay Multifocal Lens Design Overview
MyDay Multifocal lenses feature a unique Non-Rotating Vision Zones design, ensuring consistent visual clarity at all distances. These zones utilize a center-distance addition, offering a smooth transition between near, intermediate, and far vision.
The lens incorporates Water Gradient Technology, mimicking the natural hydration of the cornea for exceptional comfort, even late in the day. This design minimizes end-of-day dryness and enhances lens wearability.
Multiple add powers are available, allowing for precise customization based on the patient’s refractive error and visual needs. The design prioritizes binocular vision and minimizes aberrations.
Using the ACUVUE Multifocal Fitting Calculator
The ACUVUE Multifocal Fitting Calculator is a crucial tool for initial lens selection. Input the patient’s refraction, including distance and near additions, corneal curvature, and pupil size. The calculator suggests starting parameters, streamlining the fitting process.
It considers various factors to predict optimal add power and lens design. Remember to utilize over-refraction techniques during the trial fitting to refine the prescription. The calculator isn’t a replacement for clinical judgment, but a valuable starting point.
Regularly updated with the latest data, it helps achieve successful multifocal contact lens fits, maximizing patient satisfaction and visual performance.
Initial Lens Selection and Trial Fitting
Initial lens selection, guided by the ACUVUE Multifocal Fitting Calculator, provides a strong starting point. Begin with a spherical equivalent refraction and the recommended add power. Trial fitting involves dispensing a pair of lenses – one for each eye – with slightly differing add powers.
This allows for subjective refinement based on patient responses. Ensure proper lens centration and movement are observed. Utilize over-refraction to fine-tune the prescription, addressing any visual aberrations. Patient comfort is paramount; assess for any irritation or dryness.
Thorough evaluation during the trial phase maximizes the likelihood of a successful final fit.
Determining Trial Lens Parameters
Trial lens parameters begin with the patient’s refraction and corneal curvature. The ACUVUE Multifocal Fitting Calculator suggests initial power, diameter, and base curve. Typically, start with a +0.75D add power difference between the two eyes – one with the calculated add, the other +0.75D less.
Consider the patient’s lifestyle and visual demands when selecting parameters. For significant near work, a higher add power may be beneficial. Evaluate astigmatism; toric multifocal options are available. Always prioritize lens comfort and centration during parameter selection.
Document all chosen parameters for accurate follow-up.
Over-Refraction Techniques
Over-refraction is crucial for refining MyDay Multifocal fits. After initial trial lens application, perform a subjective refraction over the lenses. This assesses residual refractive error and helps optimize visual acuity at all distances.
Start with distance correction, then near, and finally intermediate. Small adjustments (+/- 0.25D) can significantly improve vision. Pay attention to patient responses regarding clarity and comfort. Note any fluctuations or haloes reported.
Document over-refraction results meticulously. This data guides parameter adjustments, ensuring the final prescription delivers optimal binocular vision and minimizes visual disturbances.
Assessing Visual Performance
Comprehensive visual assessment is paramount with MyDay Multifocal lenses. Evaluate distance, intermediate (typically 40cm), and near (reading distance) acuity with and without the lenses. Record best-corrected visual acuity for each distance.
Beyond acuity, assess binocularity and stereopsis using appropriate tests. Ensure comfortable and efficient binocular vision at all distances. Investigate potential issues like suppression or reduced depth perception.
Question patients about real-world visual experiences – driving, computer use, reading. Address any complaints of haloes, glare, or fluctuations. Thorough assessment ensures optimal performance and patient satisfaction.
Distance, Intermediate, and Near Vision Acuity
Measure best-corrected visual acuity at distance (6m), intermediate (40cm – computer distance), and near (reading distance, typically 30-40cm) with the trial lenses in situ. Record acuity for each eye individually, then binocularly.
Compare these results to the patient’s pre-lens refraction. Aim for at least 20/25 at distance, 20/30 at intermediate, and 20/40 at near. Note any significant differences or compromises.
Utilize a standardized chart and consistent lighting. Document all findings meticulously. These measurements are crucial for determining lens success and guiding parameter adjustments.
Binocularity and Stereopsis Evaluation
Assess binocular vision thoroughly, as multifocal lenses can impact fusion ranges. Evaluate phoria at distance and near using cover testing. Check for any induced phorias or tropias with the trial lenses in place.
Stereopsis, the ability to perceive depth, is vital. Utilize a stereo fly test or other appropriate method to quantify stereoscopic vision. A reduction in stereopsis can indicate an issue with the lens fit or design.
Monocular occlusion can reveal imbalances. Document any binocular vision anomalies and consider their impact on the patient’s daily activities. Address any concerns before finalizing the fit.
Addressing Common Fitting Issues
Haloes and glare can occur with multifocal lenses, particularly at night. Reduce add power or adjust lens design if significant. Fluctuations in vision may indicate insufficient add power or lens instability; refine parameters accordingly.
Lens centration and movement are crucial. Ensure proper centration to maximize optical zone coverage. Excessive movement can cause visual disturbances. Consider adjusting base curve or diameter.
Patient feedback is key. Thoroughly investigate complaints of blurred vision or discomfort. Don’t hesitate to revert to previous parameters or explore alternative designs if needed. Careful troubleshooting ensures optimal patient satisfaction.
Haloes and Glare Management
Haloes and glare are frequent complaints with multifocal contact lenses, often exacerbated in low-light conditions. Initial management involves reducing the add power, as excessive plus power can contribute to these visual phenomena.
Lens design adjustments can also be beneficial; exploring different add power distributions may minimize unwanted light scattering. Ensure optimal lens centration and fit, as decentration can worsen glare.
Thorough patient questioning regarding driving at night is essential. If issues persist, consider a trial with a different multifocal design or explore monovision as an alternative.
Fluctuations in Vision
Fluctuating vision with MyDay Multifocal lenses can stem from several factors, including tear film instability or dynamic lens movement. A comprehensive tear film assessment is crucial, addressing any deficiencies with appropriate lubrication.
Evaluate lens fit carefully; excessive movement can cause inconsistent vision. Adjusting the base curve or diameter may improve stability. Consider a slight over-minus refraction to enhance near vision clarity, but monitor for distance acuity compromise.
Patient education regarding lens handling and consistent wear is vital. Encourage regular lens cleaning and avoid extended digital screen time without breaks.
Lens Centration and Movement
Optimal MyDay Multifocal lens performance hinges on proper centration and minimal decentration. Assess lens position in all gazes – primary and secondary – to ensure the add power aligns with the pupil. Excessive movement can induce fluctuating vision and compromise clarity.
Corneal topography helps identify irregular astigmatism impacting lens stability. Adjust lens diameter or base curve to improve centration. Evaluate blink dynamics; incomplete blinks can displace the lens.
If decentration persists, consider alternative lens designs or parameters. Patient education on proper insertion and removal techniques is essential for maintaining optimal lens positioning.
Refinement and Finalization
Refinement of the MyDay Multifocal fit involves subtle adjustments to add power and lens parameters based on patient feedback and objective measurements. Don’t hesitate to make small changes – a 0.25D adjustment can significantly impact visual acuity.
Confirm binocularity and stereopsis are optimized. Thoroughly educate patients on proper lens care, handling, and wearing schedules. Emphasize the importance of compliance for long-term success.
A successful finalization ensures comfortable, clear vision at all distances. Schedule a follow-up appointment to assess ongoing performance and address any emerging concerns, solidifying patient satisfaction.
Adjusting Add Power and Lens Parameters
Adjusting add power is crucial for optimizing MyDay Multifocal vision. Start with small increments – 0.25D changes – based on patient reports of near or intermediate vision blur. Consider patient lifestyle; more near work may necessitate a higher add.
Lens parameter adjustments, like diameter or base curve, can improve centration and comfort. If haloes or glare persist, explore different add powers or lens designs. Utilize the ACUVUE fitting calculator for guidance.
Remember, refinement is iterative. Document all changes and patient responses to track progress towards optimal visual performance and comfort.
Patient Education on Lens Care and Wear
Comprehensive patient education is vital for MyDay Multifocal success. Emphasize proper handwashing and cleaning routines with multipurpose solution, avoiding tap water. Explain the daily disposable nature – no cleaning is required, but proper handling is key.
Discuss expected adaptation time and potential initial fluctuations. Advise patients to avoid extended wear beyond prescribed parameters. Highlight the importance of regular aftercare appointments for monitoring and addressing any concerns.
Reinforce the benefits of Water Gradient Technology for comfort, but stress adherence to recommended wearing schedules for optimal eye health and vision.
Water Gradient Technology in MyDay Multifocal
MyDay Multifocal lenses feature Alcon’s innovative Water Gradient Technology, mimicking the natural hydration of the cornea. The lens core maintains optimal hydration, while the surface boasts an ultra-thin, hydrophilic layer with a water content exceeding 80%.
This gradient creates exceptional comfort, even late in the day, reducing end-of-day dryness and irritation. The technology promotes breathability, enhancing oxygen permeability for healthier eyes. It contributes to consistent wettability, supporting clear vision throughout wear.
Ultimately, Water Gradient Technology elevates the overall contact lens wearing experience, particularly beneficial for presbyopic patients;
TOTAL30 Multifocal Lens Features
TOTAL30 Multifocal lenses represent a significant advancement in multifocal contact lens technology, being the first monthly Water Gradient option. They deliver exceptional comfort, feeling like nothing even after 30 days of continuous wear. This is due to the high water content and unique gradient design.
These lenses provide excellent visual acuity across all distances – near, intermediate, and far – catering to the diverse visual needs of presbyopes. The proven Alcon design ensures consistent performance and reduced visual disturbances.
TOTAL30 Multifocal is designed for a superior wearing experience and optimized vision correction.
Long-Term Follow-Up and Monitoring
Consistent follow-up is crucial after initiating MyDay Multifocal lens wear. Schedule initial check-ups at 1-2 weeks, then at 1 month, 3 months, and annually thereafter to assess lens performance and ocular health.
Monitor patient feedback regarding vision quality at all distances, noting any reported haloes, glare, or fluctuations. Evaluate lens centration, movement, and corneal response during each visit. Address any emerging issues promptly.
Regular monitoring ensures continued comfort, optimal vision, and minimizes potential complications, maximizing the long-term success of MyDay Multifocal lens wear.
Troubleshooting Difficult Cases
Persistent issues with MyDay Multifocal lenses may require alternative strategies. Monovision, fitting one eye for distance and the other for near, can be considered if multifocal adaptation proves challenging.
Hybrid fitting approaches, combining a multifocal lens with a single vision lens, may also improve visual outcomes. Thoroughly discuss the pros and cons of each option with the patient.
Carefully re-evaluate refraction, lens parameters, and tear film status. Don’t hesitate to consult with a colleague or specialist for complex cases, ensuring optimal patient care and satisfaction.
Monovision Considerations
Monovision with MyDay Multifocal involves fitting one eye with a distance correction and the other with a near add power. This approach can be beneficial for patients struggling to adapt to multifocal designs, offering clear vision at specific distances.
Thorough patient counseling is crucial, explaining the potential trade-offs, including reduced binocularity and depth perception; A trial period with diagnostic lenses is essential to assess tolerance and visual performance.
Carefully monitor patient adaptation, addressing any complaints of glare, haloes, or reduced contrast sensitivity. Successful monovision relies on individual patient needs and expectations.
Hybrid Fitting Approaches
Hybrid fitting combines MyDay Multifocal lenses with other strategies to optimize vision correction. This may involve a modified monovision approach, utilizing a multifocal in the dominant eye and a distance correction in the non-dominant eye.
Another technique is aspheric multifocal designs, potentially reducing aberrations and improving visual clarity. Careful refraction and over-refraction are vital to fine-tune the prescription and address individual optical needs.
Consideration of corneal topography helps identify and manage astigmatism, enhancing lens fit and visual outcomes. Hybrid approaches require meticulous assessment and patient communication to achieve optimal results.
Resources and Further Learning
Alcon provides comprehensive resources for MyDay Multifocal fitting, including the ACUVUE Multifocal Fitting Calculator, aiding in precise lens selection. Access detailed fitting guides and clinical studies on the Alcon website for in-depth knowledge.
Optometry Vis Sci publications feature research on multifocal contact lens performance, offering valuable insights. Explore articles discussing center-distance multifocal designs and myopia control paradigms.
CooperVision workshops, like the “In a muddle with multifocals?” session at 100 Optical 2024, provide practical guidance. Continuing education courses focused on presbyopia and multifocal lenses enhance clinical expertise.